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Effect of Previous Corticosteroid Treatment on Temporal Artery Biopsy Results
- Antonio A. Achkar, MD;
- Gene G. Hunder, MD; and
- Sherine E. Gabriel, MD, MSc
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
TO THE EDITOR:
This letter is in response to the letter of Dr. Ruiz-Irastorza [1] commenting on our paper [2], which was published more than 3 years ago. Dr. Ruiz-Irastorza describes our study as “inconclusive”; suggests that in two later reports [3, 4], we refer back to the conclusions of the original study as “unquestionable”; and describes this as “changing conclusions without changing evidence.” These statements are incorrect.
We believe that Dr. Ruiz-Irastorza misunderstood certain aspects of our work. We sought to determine the effect of previous corticosteroid treatment on the results of temporal artery biopsy. The study sample comprised 535 patients who underwent temporal artery biopsy at the Mayo Clinic from 1988 to 1991. We determined, from the medical records, whether each patient had received corticosteroid treatment before biopsy. Each biopsy specimen was re-examined by the study pathologist without knowledge of whether steroids had been received before biopsy.
Our main result was that biopsy findings were positive in 31% of patients who did not receive corticosteroids before biopsy and in 35% of patients who received corticosteroids before biopsy (95% CI for the difference in positivity rates, −4.7% to 11.5%). The results did not prove that histologic features are totally unaffected by corticosteroids, but they did show that in a large sample, the positivity rates of temporal artery biopsy were similar in untreated and corticosteroid-treated patients. Temporal artery biopsy may show arteritis even after more than 14 days of corticosteroid treatment in the presence of clinical indications of active disease. These conclusions, as well as the strengths and limitations of our study, were carefully detailed in the original article [2]. All subsequent references to these conclusions were accurate and provided the citation of the original article.
Antonio A. Achkar, MD
University of Pittsburgh Medical Center; Pittsburgh, PA 15213
Gene G. Hunder, MD
Sherine E. Gabriel, MD, MSc
Mayo Clinic; Rochester, MN 55905
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
